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1.
J Urol ; 205(1): 68-77, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32856981

RESUMO

PURPOSE: Encrustation is a common phenomenon that can occur following placement of a ureteral stent into the urinary tract, and it can lead to serious complications. The following review addresses the mechanism of encrustation, the management of these stents and the newest technology developed to mitigate this issue. MATERIALS AND METHODS: We performed a comprehensive literature search on stent encrustation including peer-reviewed publications, public product listings, and material on current and future stent technology. RESULTS: The mechanism of encrustation is complex and multifaceted, including dwell time, patient specific risk factors, conditioning film formation, biofilm formation and mineral deposition. Several technological developments in stent materials and coatings may have a role in reducing the risk of stent encrustation. It is important to identify the extent of stent encrustation and plan treatment strategies accordingly. We propose a novel treatment algorithm for the management encrusted ureteral stents. CONCLUSIONS: The ubiquity of ureteral stents in urology practice mandates updated knowledge about the prevention of stent encrustation, identification of high risk patients and preparedness for removal using multimodal techniques.


Assuntos
Calcinose/cirurgia , Remoção de Dispositivo/métodos , Complicações Pós-Operatórias/cirurgia , Stents/efeitos adversos , Ureter/cirurgia , Calcinose/epidemiologia , Calcinose/etiologia , Calcinose/prevenção & controle , Cistoscopia , Dilatação/efeitos adversos , Dilatação/instrumentação , Humanos , Litotripsia , Masculino , Nefrostomia Percutânea , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Desenho de Prótese , Fatores de Risco , Tecnologia , Tomografia Computadorizada por Raios X , Ultrassonografia , Ureter/diagnóstico por imagem , Ureter/microbiologia , Ureter/patologia , Obstrução Ureteral/cirurgia , Ureterolitíase/etiologia , Ureterolitíase/prevenção & controle
2.
PLoS One ; 15(12): e0243232, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326424

RESUMO

AIM: This study explores the association between Coronary Artery Calcium (CAC) scores and dental pathology such as missing teeth, the (peri-apical) health status and restoration grade of the teeth, and the grade of alveolar bone loss seen on a dental panoramic radiograph (Orthopantomograph-OPG). MATERIALS AND METHODS: In this retrospective cross-sectional study, data was collected from three hospitals spread in the Netherlands. Patients were included when a CAC score and an OPG were available, both recorded within a maximum period of 365 days from 2009-2017. The CAC score was measured on a CT scan, using the Agatston method. To assess dental pathology, the number of missing teeth, the number of dental implants, alveolar bone loss, caries, endodontic treatments, peri-apical radiolucencies, bone loss at implants, impacted teeth and dental cysts, were determined on the OPG. All observers were calibrated. The electronic health records provided information about: gender, age, smoking, Diabetes Mellitus, hypercholesterolemia, hypertension and Body Mass Index (BMI). RESULTS: 212 patients were included. We found a statistically significant association between the number of missing teeth and the CAC score. When modeling age, sex, and other well-known risk factors for cardiovascular disease, the significant correlation was no longer present after multivariate correction. Furthermore, the results showed a trend for more teeth with peri-apical lesions and a higher percentage of mean alveolar bone loss in the group with the highest CAC scores. CONCLUSION: This study showed that being edentulous or missing teeth is correlated to higher CAC scores however failed to be an independent predictor of atherosclerotic cardiovascular diseases. The number of (missing) teeth is an easily accessible marker and could be used as a marker for atherosclerotic cardiovascular disease (ACVD) risk by almost any healthcare worker. The current study needs to be considered as an explorative pilot study and could contribute to the design of further (prospective) studies on the relationship between dental pathology and coronary artery calcification by adding clinical information and extra cardiovascular biomarkers.


Assuntos
Calcinose/etiologia , Cálcio/análise , Vasos Coronários/patologia , Perda de Dente/complicações , Adulto , Idoso , Aterosclerose/etiologia , Aterosclerose/patologia , Calcinose/patologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Retrospectivos , Fatores de Risco , Perda de Dente/patologia
3.
BMJ Case Rep ; 13(12)2020 Dec 28.
Artigo em Inglês | MEDLINE | ID: mdl-33372025

RESUMO

Cardiac disease after mediastinal radiotherapy can result in progressive valvular thickening and dystrophic calcification with ensuing leaflet restriction and dysfunction. This can ultimately manifest as valvular stenosis and/or regurgitation. We report a case of a 61-year-old woman with symptomatic severe aortic stenosis and severe mitral stenosis due to severe dystrophic calcification postmediastinal radiotherapy for lymphoma. She was deemed surgically inoperable due to dense, continuous calcification throughout the leaflets and annuli of both valves, aortomitral continuity, proximal coronary arteries and proximal porcelain aorta. She underwent simultaneous transcatheter aortic valve replacement and transcatheter mitral valve replacement with an excellent technical and clinical result at 7-month follow-up. We also describe the central role of multimodality three-dimensional transoesophageal echocardiography and multidetector cardiac CT imaging in assessing the severity of valve disease, characterising the nature of cardiac calcification and guiding decisions on surgical operability and transcatheter intervention.


Assuntos
Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/cirurgia , Calcinose/complicações , Doenças das Valvas Cardíacas/complicações , Estenose da Valva Mitral/diagnóstico por imagem , Estenose da Valva Mitral/cirurgia , Radioterapia/efeitos adversos , Estenose da Valva Aórtica/etiologia , Calcinose/etiologia , Ecocardiografia Transesofagiana , Feminino , Doenças das Valvas Cardíacas/etiologia , Implante de Prótese de Valva Cardíaca , Doença de Hodgkin/radioterapia , Humanos , Neoplasias do Mediastino/radioterapia , Pessoa de Meia-Idade , Valva Mitral/cirurgia , Estenose da Valva Mitral/etiologia , Tomografia Computadorizada Multidetectores , Imagem Multimodal , Substituição da Valva Aórtica Transcateter
4.
Angiol Sosud Khir ; 26(4): 17-22, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33332302

RESUMO

The number of patients with diabetes mellitus has steadily been increasing. This disease is associated with the risk for the development of micro- and macroangiopathies. One of the variants of macroangiopathy is Mönkeberg's sclerosis characterized by the presence of calcification of the media of the arterial wall. This article is a literature review reflecting the role of calcification in arterial lesions in patients with diabetes mellitus, also covering the historical aspect of studying Mönkeberg's sclerosis. Special attention is paid to its morphological forms, aetiopathogenetic mechanisms of development, taking into account contemporary studies, demonstrating mechanisms of the effect of medial arterial calcification on haemodynamics and the risk for the development of cardiovascular complications. Also presented herein are the main non-invasive and invasive methods of its diagnosis.


Assuntos
Arteriosclerose , Calcinose , Diabetes Mellitus , Calcificação Vascular , Artérias/patologia , Calcinose/diagnóstico , Calcinose/etiologia , Humanos , Fatores de Risco , Esclerose/patologia , Calcificação Vascular/diagnóstico , Calcificação Vascular/etiologia , Calcificação Vascular/patologia
5.
Medicine (Baltimore) ; 99(46): e23299, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181720

RESUMO

Calcific tendinitis (CT) of the shoulder is a painful disorder usually identified in individuals aged 40 and 60 years. The estimated global prevalence of CT is 2.7% to 36%. We examined the association of hyperlipidemia and sex with CT of the shoulder using Taiwan Biobank (TWB) and the National Health Insurance Research Database (NHIRD).Data were available for 9903 TWB participants who were recruited between 2008 and 2015. We used multiple logistic regression analysis to estimate the odds ratios (OR) and 95% confidence intervals (CI) for CT of the shoulder.Overall, 1564 women, and 1491 men were identified with hyperlipidemia. Women, compared to men, had higher odds of CT of the shoulder (OR, 1.53; 95% CI, 1.08-2.16). Hyperlipidemia, compared to no hyperlipidemia, was associated with an increased risk of CT (OR, 1.40; 95% CI, 1.02-1.93). The test for interaction was significant for sex and hyperlipidemia (P = .006). After stratification, the odds ratio for CT was 1.95 (95% CI, 1.30-2.92) in women and 0.82 (95% CI, 0.48-1.39) in men, respectively. Compared to men with no hyperlipidemia, the odds ratio was 0.86 (95% CI, 0.53-1.38) for men with hyperlipidemia and 2.00 (95% CI, 1.29-3.10) for women with hyperlipidemia.Importantly, our findings indicated that the risk for CT of the shoulder was higher among Taiwanese women with hyperlipidemia. However, CT risk among their male counterparts with hyperlipidemia was not significant.


Assuntos
Calcinose/etiologia , Hiperlipidemias/complicações , Artropatias/etiologia , Fatores Sexuais , Ombro/anormalidades , Tendinopatia/etiologia , Doenças Vasculares/etiologia , Adulto , Idoso , Calcinose/epidemiologia , Calcinose/fisiopatologia , Feminino , Humanos , Hiperlipidemias/epidemiologia , Hiperlipidemias/fisiopatologia , Artropatias/epidemiologia , Artropatias/fisiopatologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Ombro/fisiopatologia , Taiwan/epidemiologia , Tendinopatia/epidemiologia , Tendinopatia/fisiopatologia , Doenças Vasculares/epidemiologia , Doenças Vasculares/fisiopatologia
7.
Dermatol Online J ; 26(6)2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32815688

RESUMO

Calcinosis cutis, although common in systemic sclerosis, has been rarely reported in patients with morphea. We describe four patients with calcinosis cutis arising within morphea plaques, discuss their treatments and outcomes, and review previously published cases. Current management recommendations for concomitant morphea and dystrophic calcinosis cutis are based on limited data and expert opinion, which has primarily focused on reduction of active inflammation and reduction of symptoms related to calcinosis or ulceration. In most cases, no improvement of calcinosis was noted. The use of intralesional corticosteroids to active lesions in conjunction with systemic treatment, including methotrexate when indicated, appear promising treatments to halt progression of the disease. Surgical excision seems to be the most definitive treatment for calcinosis affecting morphea plaques, but the current literature lacks details regarding disease recurrence following operative management.


Assuntos
Calcinose/etiologia , Esclerodermia Localizada/complicações , Dermatopatias/patologia , Pele/patologia , Corticosteroides/uso terapêutico , Calcinose/patologia , Calcinose/cirurgia , Criança , Feminino , Humanos , Injeções Intralesionais , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Esclerodermia Localizada/tratamento farmacológico , Esclerodermia Localizada/patologia , Dermatopatias/terapia
9.
Anticancer Res ; 40(7): 4191-4198, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620669

RESUMO

BACKGROUND/AIM: Tumoral calcification after chemotherapy or radiation therapy has been reported in various cancer patients, but not after radioembolization. The purpose of this study was to evaluate the prognostic value of radioembolization-induced tumor calcification of hepatocellular carcinoma (HCC) treated by radioembolization. PATIENTS AND METHODS: This retrospective study comprised patients with single nodular HCC who underwent yttrium-90 radioembolization between November 2015 and April 2019. The presence of tumoral calcification was visually assessed on a follow-up computed tomography (CT) scan. RESULTS: Fifty-five patients (64.8±11.8 years, 43 men) were evaluated. Tumoral calcification was present in 21 (38.2%) of 55 patients in the one-month CT scan (calcification group). The complete response rate for the primary index tumor was 72.7% (40 of 55) in the total study population, and 100% (21 of 21) in the calcification group, respectively. The calcification group had a longer local progression-free survival rate than the non-calcification group (p=0.017). CONCLUSION: Radioembolization-induced tumoral calcification is relatively common and can be used as an early surrogate marker of complete response.


Assuntos
Calcinose/etiologia , Carcinoma Hepatocelular/terapia , Embolização Terapêutica , Neoplasias Hepáticas/terapia , Compostos Radiofarmacêuticos/uso terapêutico , Radioisótopos de Ítrio/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Calcinose/diagnóstico por imagem , Carcinoma Hepatocelular/diagnóstico por imagem , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Prognóstico , Tomografia Computadorizada por Raios X
10.
Arch Osteoporos ; 15(1): 106, 2020 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-32700242

RESUMO

In this report, we describe the case in which tumoral calcinosis occurs in a patient afflicted with psoriatic arthritis. INTRODUCTION: Tumoral calcinosis is a benign disease which occurs quite rarely. It is similar to a neoplasm and appears as the result of calcium deposition in the soft tissues around large joints. This disease can develop as a primary or secondary disease in patients. CASE REPORT: In this report, the authors describe the case in which tumoral calcinosis occurs in a female afflicted with psoriatic arthritis. We review the patient's clinical and para clinical findings. CONCLUSIONS: Our report is the first one in which an Iranian patient with psoriatic arthritis has been diagnosed to have tumoral calcinosis. Imaging and pathological examinations are the common diagnostic methods. The main treatment for that is tumor resection.


Assuntos
Artrite Psoriásica , Calcinose , Artrite Psoriásica/complicações , Artrite Psoriásica/diagnóstico por imagem , Calcinose/complicações , Calcinose/diagnóstico por imagem , Calcinose/etiologia , Feminino , Humanos , Irã (Geográfico) , Síndrome
11.
Medicine (Baltimore) ; 99(29): e21286, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702920

RESUMO

Calcific aortic valve disease (CAVD) is highly prevalent in our aging world and has no effective pharmaceutical treatment. Intense efforts have been made but the underlying molecular mechanisms of CAVD are still unclear.This study was designed to identify the critical genes and pathways in CAVD by bioinformatics analysis. Microarray datasets of GSE12644, GSE51472, and GSE83453 were obtained from Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified and functional and pathway enrichment analysis was performed. Subsequently, the protein-protein interaction network (PPI) was constructed with Search Tool for the Retrieval of Interacting Genes and was visualized with Cytoscape to identify the most significant module. Hub genes were identified by Cytoscape plugin cytoHubba.A total of 179 DEGs, including 101 upregulated genes and 78 downregulated genes, were identified. The enriched functions and pathways of the DEGs include inflammatory and immune response, chemotaxis, extracellular matrix (ECM) organization, complement and coagulation cascades, ECM receptor interaction, and focal adhesion. The most significant module in the PPI network was analyzed and genes among it were mainly enriched in chemotaxis, locomotory behavior, immune response, chemokine signaling pathway, and extracellular space. In addition, DEGs, with degrees ≥ 10 and the top 10 highest Maximal Chique Centrality (MCC) score, were identified as hub genes. CCR1, MMP9, VCAM1, and ITGAX, which were of the highest degree or MCC score, were manually reviewed.The DEGs and hub genes identified in the present study help us understand the molecular mechanisms underlying the pathogenesis of CAVD and might serve as candidate therapeutic targets for CAVD.


Assuntos
Estenose da Valva Aórtica/genética , Valva Aórtica/patologia , Calcinose/genética , Genes/genética , Predisposição Genética para Doença/genética , Estenose da Valva Aórtica/etiologia , Calcinose/etiologia , Estudos de Casos e Controles , Biologia Computacional , Genes/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Sequência com Séries de Oligonucleotídeos
13.
Ann Biol Clin (Paris) ; 78(4): 349-362, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32540796

RESUMO

The prevalence of crystalline pathologies including urolithiasis, gallstones, vascular calcifications and crystalline arthritis, is very high in the general population beyond 60 years old. Characterization of microcrystals in tissue at the micrometer and at the nanometer scale through physico-chemical techniques constitutes a new opportunity for the physician to decipher the early stage of the pathogenesis of these biological entities. In this review, such description indicates a wide variety of the chemical process associated to the nucleation process directly from supersaturated solution or from organic support such as DNA or elastin. We will also discuss the case of vesicles which play a major role in the case of ectopic calcification situated in kidney tissue, namely the Randall's plaque. All this research focused on the very first steps of the genesis of pathological calcifications constitute a major step to develop specific therapy able to avoid the formation of these abnormal deposits in tissues. As already underlined, crystals may be the consequence of various pathologies, but they are also involved in the dysfunction of the tissues.


Assuntos
Calcinose/etiologia , Cristalização , Litíase/etiologia , Calcinose/metabolismo , Calcinose/patologia , Humanos , Cálculos Renais/etiologia , Cálculos Renais/metabolismo , Cálculos Renais/patologia , Litíase/metabolismo , Litíase/patologia , Urolitíase/etiologia , Urolitíase/metabolismo , Urolitíase/patologia , Calcificação Vascular/etiologia , Calcificação Vascular/metabolismo , Calcificação Vascular/patologia
14.
Rev. chil. radiol ; 26(2): 52-61, jun. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1126194

RESUMO

Resumen: La tendinopatía cálcica es causada por el depósito patológico de cristales de hidroxiapatita de calcio en los tendones y es una causa común de dolor en las articulaciones. Afecta más frecuentemente al hombro y la cadera, con hallazgos característicos en imágenes; sin embargo, cualquier tendón puede estar involucrado. Ocasionalmente, la tendinopatía cálcica puede simular patología agresiva, como infección o neoplasia, especialmente en RM. Fisiotpatológicamente, las calcificaciones provendrían de una diferenciación anormal de las células madre del tendón, que comienzan a producir calcio, aunque todavía no es del todo claro. Los radiólogos deben estar familiarizados con los hallazgos de las imágenes para distinguir la tendinopatía cálcica de procesos más agresivos. La aspiración y lavado guiado bajo ecografía es una técnica útil realizada por el radiólogo para el tratamiento de casos sintomáticos. La familiaridad con estos procedimientos y su apariencia en imágenes es un aspecto importante en el manejo de esta enfermedad. El propósito de esta revisión es analizar la etiopatogenia de la tendinopatía cálcica, la evaluación con imágenes en los sitios de presentación más comunes y también en los menos frecuentes, así como el papel que desempeña la ecografía en el tratamiento de la patología.


Abstract: Calcific tendinitis is caused by abnormal deposition of calcium hydroxyapatite crystals in tendons and is a common cause of joint pain. The disease typically affects the shoulder and hip, with characteristic imaging findings; however, any tendon can be involved. Occasionally, calcific tendinitis can mimic aggressive disorders, such as infection and neoplasm, especially on MRI. Apparently, the calcifications come from an abnormal differentiation of the tendon stem cells, which begin to produce calcium. Radiologists should be familiar with the imaging findings to distinguish calcific tendinitis from more aggressive processes. Image-guided percutaneous needle aspiration is a useful technique performed by the radiologist for the treatment of symptomatic cases. Being familiar with these processes and their imaging appearance is an important aspect in the management of this common disease. The purpose of this review is to analyze the pathogenesis of calcium tendinopathy, the evaluation of images in both the most common and less frequent presentation sites, as well as the role played by ultrasound in the treatment of pathology.


Assuntos
Humanos , Calcinose/etiologia , Calcinose/diagnóstico por imagem , Manguito Rotador/diagnóstico por imagem , Tendinopatia/etiologia , Tendinopatia/diagnóstico por imagem , Ultrassom , Calcinose/classificação , Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X , Tendinopatia/classificação
15.
World Neurosurg ; 140: 65-70, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32417224

RESUMO

BACKGROUND: Chronic subdural hematoma associated with dural calcifications in previously pediatric shunted patients is a rare condition. The inner dural membrane opening can lead to progressive brain herniation into the subdural space due to brain reexpansion. CASE DESCRIPTION: A 15-year-old boy, previously shunted at birth for congenital hydrocephalus, presented with a giant chronic right hemispheric subdural hematoma. After 2 surgical procedures in which the subdural calcified neomembrane was opened and a subdural shunt was implanted, he developed a cortical brain herniation into the subdural space, resulting in brain ischemia and upper limb weakness and vomiting. The final surgical treatment consisted of an extensive wide peeling of visceral calcified membrane mutually to programmable valve placement along the subduroperitoneal shunt, in order to create a positive gradient between the subdural space and the ventricles. The patient experienced a prompt clinical improvement. CONCLUSIONS: This case illustrates a rare complication of the treatment of a chronic subdural hematoma caused by insufficient opening of the calcified inner mambrane of the hematoma and encouraged by gradient pressure between the ventricular and subdural compartments. To avoid this complication, it is preferable to not open a thick, calcified, unelastic inner membrane. However, in case of lack of clinical and radiologic improvement, it may become necessary to open it: a wide opening should be attempted, in order to prevent brain strangulation.


Assuntos
Encefalocele/etiologia , Hematoma Subdural Crônico/cirurgia , Procedimentos Neurocirúrgicos/efeitos adversos , Complicações Pós-Operatórias/etiologia , Adolescente , Calcinose/etiologia , Calcinose/cirurgia , Derivações do Líquido Cefalorraquidiano/efeitos adversos , Hematoma Subdural Crônico/etiologia , Humanos , Doença Iatrogênica , Masculino , Procedimentos Neurocirúrgicos/métodos
16.
BMC Cardiovasc Disord ; 20(1): 252, 2020 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-32460708

RESUMO

BACKGROUND: Peripherally inserted central catheters (PICCs) are widely used in cancer patients for administering chemotherapy drugs, antibiotics, and nutrients. PICC-related thrombi are not uncommon and may result in pulmonary embolism and the formation of thrombi in the right atrium. The latter are associated with an increased risk of subsequent morbidity or mortality because of their potential for embolization in the pulmonary vasculature. CASE PRESENTATION: A 16-year-old male with acute lymphoblastic leukemia (ALL) was admitted to our hospital after an echocardiographic examination revealed a ring-like structure in the right atrium that was still present after 6 months' anticoagulation treatment with aspirin. The boy had had a PICC inserted 2 years previously for chemotherapy; the PICC was intact and successfully removed 18 months after insertion when chemotherapy is finished. Subsequent computer tomography and radiography differentiated right atrial ring-shaped mass with a diameter of approximately 15 mm. Cardiac surgery was performed to remove the mass which was found to be a calcified thrombus. CONCLUSION: Although this is a rare occurrence, recognition of the possibility of a calcified thrombus may minimize the misdiagnosis of PICC-related thrombus and allow surgical retrieval if the thrombus is sufficiently large.


Assuntos
Antineoplásicos/administração & dosagem , Calcinose/cirurgia , Cateterismo Periférico/efeitos adversos , Átrios do Coração/cirurgia , Cardiopatias/cirurgia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Trombose/cirurgia , Adolescente , Calcinose/diagnóstico por imagem , Calcinose/etiologia , Átrios do Coração/diagnóstico por imagem , Cardiopatias/diagnóstico por imagem , Cardiopatias/etiologia , Humanos , Masculino , Trombose/diagnóstico por imagem , Trombose/etiologia , Resultado do Tratamento
18.
Ren Fail ; 42(1): 483-488, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32438839

RESUMO

The coronavirus disease-19 (COVID-19) has spread over many countries and regions since the end of 2019, becoming the most severe public health event at present. Most of the critical cases developed multiple organ dysfunction, including acute kidney injury (AKI). Cytokine storm syndrome (CSS) may complicate the process of severe COVID-19 patients. This manuscript reviews the different aspects of blood purification in critically ill patients with AKI and increased inflammatory factors, and examines its potential role in severe COVID-19 treatment. Continuous renal replacement therapy (CRRT) has been practiced in many sepsis patients with AKI. Still, the timing and dosing need further robust evidence. In addition to the traditional CRRT, the high-throughput membrane with adsorption function and cytokine adsorption column are two representatives of recently emerging novel membrane technologies. Their potential in removing inflammatory factors and other toxins prospects for the treatment of severe COVID-19.


Assuntos
Betacoronavirus , Calcinose/terapia , Infecções por Coronavirus/terapia , Citocinas , Doenças das Valvas Cardíacas/terapia , Hipotricose/terapia , Pneumonia Viral/terapia , Terapia de Substituição Renal , Dermatopatias Genéticas/terapia , Calcinose/etiologia , Infecções por Coronavirus/complicações , Estado Terminal , Doenças das Valvas Cardíacas/etiologia , Humanos , Hipotricose/etiologia , Pandemias , Pneumonia Viral/complicações , Dermatopatias Genéticas/etiologia
19.
Int J Cardiovasc Imaging ; 36(8): 1593-1598, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32342245

RESUMO

18F-sodium fluoride (18F-NaF) has been used to access aortic stenosis in clinical research setting. It is known that its uptake is related with microcalcification. The purpose of this study was to assess the relationship between 18F-NaF uptake by the aortic valve and cardiovascular risk. Twenty-five patients with risk factors for cardiovascular disease, without known cardiovascular disease or aortic stenosis underwent PET-CT with 18F-NaF. Cardiovascular risk was assessed through the ASCVD (Atherosclerotic Cardiovascular Disease) risk calculator. Aortic valve 18F-NaF (AoVCUL) uptake was evaluated through the corrected uptake per lesion (CUL = max SUV - mean blood-pool SUV). Calcium score was obtained through cardiac CT. The patients present a mean age of 63.90 ± 8.60 years and 56% males. The mean ASCVD was of 28.76 ± 18.96 (M 25, IQR 38.50). The mean aortic valve calcium score (AoVCaSc) was of 53.24 ± 164.38 (M 6; IQR 29.75) and the AoVCUL was of 0.50 ± 0.10 (M 0.52, IQR 0.15). The patients were classified according to the ASCVD: patients with a risk greater or equal than the 50th percentile of the ASCVD risk and patients with a risk lower than the 50th percentile. The AoVCUL was evaluated in both groups: AoVCUL = 0.56 ± 0.10 vs 0.42 ± 0.15, p = 0.02; AoVCaSc was of 0 in 11 patients (44%) and those with an ASCVD greater or equal than the 50th percentile had a mean AoVCaSc of 8.00 ± 13.80, and those with an ASCVD risk lower than the 50th percentile had a mean AoVCaSc of 95.00 ± 223.45; p = 0.09. In this study microcalcification, evaluated through 18F-NaF on PET-CT, was related with cardiovascular risk. Although the score of calcium seems to be higher in higher cardiovascular risk patients, no significant difference was found between groups.


Assuntos
Estenose da Valva Aórtica/diagnóstico por imagem , Valva Aórtica/patologia , Calcinose/diagnóstico por imagem , Radioisótopos de Flúor/administração & dosagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos/administração & dosagem , Fluoreto de Sódio/administração & dosagem , Idoso , Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/etiologia , Doenças Assintomáticas , Calcinose/etiologia , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Medição de Risco , Fatores de Risco
20.
Immunol Med ; 43(3): 107-114, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32324110

RESUMO

Systemic sclerosis (SSc) induces skin thickening and numerous symptoms involving the entire body. Collagen deposition, immune disorder, and vascular abnormalities is currently estimated to be three major causal factors involved in the respective conditions. Vascular abnormalities usually develop in the initial phase of this disease, and may exist in all phases; therefore, they markedly influence the patient's quality of life. This article reviews recent findings about 'narrow-sense' vascular lesions (including Raynaud's phenomenon, skin ulcers, nailfold bleedings, pitting scars, telangiectasia, and pulmonary hypertension) and 'broad-sense' vascular lesions (such as calcinosis or erectile dysfunction). Affected blood vessels can be classified into arteriole/small artery and capillary blood vessels. Furthermore, pathological changes include the proliferation of the vascular endothelial or smooth muscle cells, lumen stenosis by collagen accumulation of the vascular intima, vasodilation or fragility, and apoptosis. There may be interaction between vascular lesions, autoimmune disorder, and collagen deposition. Thus, various symptoms of this disease may be controlled through the treatment of vascular lesions.


Assuntos
Qualidade de Vida , Escleroderma Sistêmico/complicações , Doenças Vasculares/etiologia , Calcinose/etiologia , Colágeno/metabolismo , Células Endoteliais/patologia , Disfunção Erétil/etiologia , Feminino , Humanos , Hipertensão Pulmonar/etiologia , Masculino , Miócitos de Músculo Liso/patologia , Doença de Raynaud/etiologia , Úlcera Cutânea/etiologia , Telangiectasia/etiologia
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